MILWAUKEE COUNTY

Health Department disarray affected services for residents in 2018, Milwaukee officials say

Alison Dirr
Milwaukee Journal Sentinel
Milwaukee Commissioner of Health Jeanette Kowalik

Newly released figures for 2018 show the impact problems at the Health Department had on services the department provides to the public, city officials say.

Health officials revealed drops in 2018 in the numbers of vaccines administered by the department, people who were seen at its Sexual and Reproductive Health Clinic and efforts to address lead in the city.

"The impact of the disarray in the Health Department had a real impact on real lives, and these numbers demonstrate that," Ald. Michael Murphy said at a meeting last week of the Finance and Personnel Committee. He called the figures that were presented shocking.

He was referencing the difference between the 8,271 vaccines administered by the department in 2017 and the 5,921 in 2018.

The city's Health Department struggled for months after it came to light that the department had failed to provide services for the families of children with lead poisoning, or at least failed to document its efforts. The fallout included the January 2018 resignation of Health Commissioner Bevan Baker.

The department also struggled with its programs for family planning, cancer screening and sexually transmitted infection testing.

Baker was replaced by interim Commissioner Patricia McManus. Current Health Commissioner Jeanette Kowalik was confirmed in September 2018.

So far this year, the figure for the number of vaccines administered stands at 4,634 and is projected to increase to 6,000 in 2020.

Even the 2020 projection is 2,271 fewer than in 2017, Murphy said, asking why there would be such significant change.

Kowalik said the department is still grappling with some anti-vaccine sentiment. That means the department needs to do a better job marketing the benefits of vaccinations and making sure the department is creating more points of contact, she said.

Wisconsin has a low rate of immunization that public health officials attribute to a national movement against vaccines that is propelled by false information.

Lindsey Page, infectious disease and immunization program manager, said another reason for the drop is that people are getting vaccines from sources other than the Health Department. She conceded, though, that there hadn't been tracking to prove that that was the case.

Sexual and Reproductive Health Clinic sees fewer people in 2018

The Health Department saw a decrease in the number of people seen at its Sexual and Reproductive Health Clinic, from 5,123 in 2017 to 4,214 in 2018.

Asked about the reason for the decrease, Kowalik said 2018 was a low point for the department, with inconsistent leadership and staffing.

People were coming for services, but staffing issues caused people to be turned away, said Julie Katrichis, the department's sexual and reproductive health program manager.

A new medical assistant has allowed the department to screen patients even if they couldn't see a nurse, raising those screenings 160%, she said.

Kowalik said the department has filled nursing vacancies, has a temporary nurse that just started and is in the process of hiring a nurse practitioner.

"If we don't have full clinical capacity, we can't see as many clients," she said after the meeting.

So far this year, 3,750 people had been seen at the clinic, and that figure is projected to increase to 5,000 in 2020.

Lead questions remain

Murphy and Ald. José Pérez pushed for additional data about lead in the city — and the department seemed close to being able to provide answers. 

“This is where statistics and science should be driving the allocation of limited financial resources,” Murphy said. 

Pérez said aldermen had been asking for data and that what he's received isn't what he needs or wants. 

"I just feel like there's a lot of analysis — or even just plain data — that we can't look at or just make sense of," he said.

Kowalik said she was also very curious about the return on investment and that her goal is to have better analysis of the data the department collects.

One of the department's primary efforts has been reorganizing the lead program, Kowalik said after the meeting. That means focusing on following up quickly with children with lead poisoning, pre- and post-inspection in the lead abatement process and outreach aimed at prevention.

Last year, the number of lead tests performed related to abatement orders — including dust wipes, soil, paint chips and water — dropped to 6,623 from 9,252 in 2017. The drop was also a reflection of the turmoil in the department, Kowalik said after the meeting.

As of September this year, the figure stood at 6,029. She said the department is working this year to get the program back on solid ground. Next year, 7,500 tests are projected to be performed. 

The department also saw a dip in 2018 in its spending on lead paint abatement to $857,773 from $1.28 million the year before.

The department thinks it has the staffing and contractor capacity to spend about $3.9 million on lead paint abatement to make about 240 units lead-safe in 2020.

The department recently recruited four new contractors, bringing its total to nine contractors.  

Kowalik said the department is in a better place with lead risk assessors, with 12 now. There are five public health nurses doing case management and the department is in the process of hiring a new public health nurse supervisor.

She said the department is also trying to repair trust with the community.

There are currently 61 vacancies across the Health Department, the bulk of which are in the maternal and child health sector of the community health branch, Kowalik said. She said the department will also have jobs available.

Contact Alison Dirr at 414-224-2383 or adirr@jrn.com. Follow her on Twitter @AlisonDirr.